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Abstract
A foreign body (FB) in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.
Introduction
Foreign body, fish bone, vocal cord
A foreign body (FB) in the upper digestive tract, especially fish bone, is a common clinical encounter in the emergency setting. Although fish bone was found to be the most prevalent FB in the upper aerodigestive tract, the incidence of fish bone impacted in the larynx is only 4.2%2 Impaction of fish bone requires urgent removal. Complications may arise due to the nature of fish bone itself, which has sharp edges that can puncture and penetrate the adjacent soft tissue.2,3 Besides that, fish bone in the larynx has the tendency to get dislodged into the lower airway. This will make the retrieval process more difficult.
Case summary
A 57-year-old Malay man, with no past medical illness, presented with a 6-hour history of odynophagia after taking breakfast with fish. He claimed that he had a bout of cough during eating. It was associated with odynophagia but there was no vomiting, shortness of breath or hoarseness of voice. Initially, he tried to remove it himself by finger manipulation but failed. He immediately came to came to the Emergency Department and was referred referred to the otorhinolaryngologist.
Examination showed that the patient was not in respiratory distress and no stridor was audible. Oropharyngeal examination...